Management of pleural effusions in breast cancer

Ninety-seven patients with breast cancer developed pleural effusions between January, 1971 and December, 1976. A retrospective analysis of 170 treatment procedures showed that 75 involved thoracocentesis alone, 23 involved thoracocentesis plus therapy with an alkylating agent, 22 involved drainage via a chest tube plus instillation of an alkylating agent, and 50 involved drainage via a chest tube plus instillation of tetracycline. The results are presented as censored survival curves. When management by chest tube plus instillation of an alkylating agent or tetracycline was compared with management by thoracocentesis plus therapy with an alkylating agent, analysis at six months after treatment showed that 42 percent (30/72) of the procedures left patients free of effusion using the former method, compared with 22 percent (5/23) of the procedures using the latter method. This is not quite significant at the 5 percent level using a summary chi2 procedure. The reasons for preferring tetracycline as a sclerosing agent are discussed.